磁共振尿路成像诊断肾移植输尿管坏死

目的:探讨磁共振尿路成像(MRU)诊断肾移植输尿管坏死的价值。材料和方法:12例肾移植术后怀疑输尿管坏死患者,临床表现为移植肾区肿痛、少尿或无尿,B超提示移植肾盂积水,输尿管扩张,移植肾周积液,用重T2WI快速自旋回波序列和脂肪抑制技术行MRU检查。结果:MRU均显示移植肾盂及肾盏扩张,输尿管上段扩张,重T2WI表现为高信号。输尿管连续性消失,其下方为局限性包裹液性区。在渗出的包裹性尿液邻近或下方可见高信号的膀胱影。12例患者均接受手术探查,术中均发现输尿管有坏死,坏死部位与MRU显示输尿管连续性消失部位一致,输尿管坏死下方可见渗出的尿液,与MRU所见局限性包裹液性区相吻合。结论:MRU诊断肾移植后输尿管坏死具有极高诊断价值。

MR Urography in the Diagnosis of Ureteral Necrosis after Kidney Transplantation

Purpose:To evaluate the diagnostic efficacy of MR urography(MRU) in the diagnosis of ureteral necrosis after kidney transplantation.Materials and Methods:12 cases with ureteral diseases after renal transplantation were studied.The patients' Clinical feature were painful lower abdomen,diuresis.B Ultrasound showed pyeloureteral dilation.MR urography were obtained by a modified,heavily T2-weighted fast apin-echo pulse sequence and fat-suppression pulse technique.Results:MRU provided high-resolution images of the kidney and urinary tract on heavily T2-weighted images in all patients.The dilated collecting systems of the transplant kidneys and interrupted ureter were clearly revealed in all cases.There were inclusion cysts near bladder.All the diagnosis of ureteral necrosis was made during surgery and defined macroscopically by the necrotic aspect of the ureter.Conclusion:MRU is a good method for assessing of ureteral necrosis after kidney transplantation.